Malaria is one of the most common infectious diseases across the globe and one of the most momentous tasks faced by public health systems in most developing countries. According to the latest World Malaria report, by the World Health Organization (WHO) there were 247 million cases of malaria in 2021 as compared to 245 million cases in 2020. The increase in the number of cases is not only troubling but also alarming. While some cases show mild symptoms, some cases could end in the death of an individual. The same study also revealed that the estimated number of malaria deaths stood at 6,19,000 in 2021.
Having said that, in grave conditions, malaria could also lead to multi-organ dysfunction. Although not related to the type of malaria acquired, the disease can cause overall discomfort to the body and organs in the lungs, kidneys, and brain. Acute Kidney Injury (AKI) is a known complication of malaria and could occur in around 40% of patients with severe disease. AKI caused due to malaria damages the kidneys leading to immune dysregulation and subsequent inflammation alongside other major physical and mental discomforts.
So, what leads to the complication of developing AKI in a malaria-infected individual? Firstly, AKI in severe malaria is caused by acute tubular necrosis and is defined by a rise in serum creatinine or a decrease in urine output. In adults with severe malaria, AKI develops in up to 40% of patients, whereas in children, the incidence is historically reported at approximately 10%.
At the onset, symptoms may be mild ranging from lower haemoglobin, higher WBC count, lower platelets, elevated ESR, total and direct bilirubin, AST, ALP, lower serum sodium, and higher serum potassium and can progress to severe symptoms like anaemia, diarrhoea, jaundice and acute kidney injury. Secondly, the symptoms vary from individual to individual as does the severity of the condition. Seeking professional medical help and tests can help contain and reduce the infection and help the individual revert to the ideal state of being.
Looking at the growing incidence of Malaria and its impact on the kidneys, the most important step in case of these complications is finding knowledgeable nephrologists, because such situations need to be tackled extremely carefully. Malaria can cause slow functioning of kidneys leading to the buildup of fluid or body waste or electrolyte problems and individuals can require hemodialysis. Individuals who suffer from kidney issues and get malaria are prone to spleen rupture as a complication. It could also lead to anaemia.
That being said, it is also undeniable that there exists a health literacy gap in India which needs to be bridged, more importantly, AKI caused due to Malaria. Although Malaria is common, its complications however are not. These complications are life-threatening in cases and need to be brought to the attention which can help with early diagnosis and regular screening in the vulnerable population.
As we move into a fast-paced world it is important to prioritize one’s health by having regular check-ups to check for any minor irregularities (if any) and take precautions accordingly. These tests also draw attention to any complications that might lead to chronic illnesses.
Kidney disease remains a huge burden on society and it is estimated that about 10% of the adult population has some form of kidney disease; 200,000 people get afflicted with severe kidney disease (end-stage kidney disease) every year and very unfortunately over 90% of them die due to lack of access and affordability of renal replacement therapy in the form of dialysis or transplantation. These staggering numbers should draw attention to the big problem we face today before it paves the way for a global epidemic of kidney diseases.